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Hepatocellular carcinoma

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Opinion statement

Early detection of hepatocellular carcinoma (HCC) is feasible, particularly in patients known to be at risk from chronic hepatitis and chronic liver disease. The optimal surveillance strategy is unknown. HCC usually presents as an incurable disease even when detected on surveillance. Surgical resection is the treatment of choice, but the coexistence of chronic liver disease and the insidious nature of HCC make it unresectable in most patients. Orthotopic liver transplantation for selected patients or ablative techniques may offer an opportunity to render patients disease-free even if the tumor is unresectable.

There are numerous therapies offered to patients with unresectable HCC, including chemotherapy, hormonal therapy, and regional intra-arterial treatments. While potentially palliative, none of these approaches has been demonstrated to prolong survival in these patients. If possible, the treatment of patients with HCC should be done on clinical trials.

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References and Recommended Reading

  1. Landis SH, Murray T, Bolden S, Wingo PA: Cancer Statistics, 1998. CA Cancer J Clin 1998, 48:6–30.

    Article  PubMed  CAS  Google Scholar 

  2. El-Serag HB, Mason AC: Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 1999, 340:745–750. This paper sounds the warning that HCC will be an increasing problem throughout the world related to the rising incidence of hepatitis C.

    Article  PubMed  CAS  Google Scholar 

  3. Zhou X-D, Tank Z-Y, Yu Y-Q, et al.: Long-term survivors after resection for primary liver cancer. Cancer 1989, 63:2201–2206.

    Article  PubMed  CAS  Google Scholar 

  4. Venook AP, Ferrell LD, Roberts JP, et al.: Liver transplantation for hepatocellular carcinoma: results with preoperative chemoembolization. Liver Trans Surg 1995, 1:242–248.

    Article  CAS  Google Scholar 

  5. Muto Y, Moriwaki H, Ninomiya M, et al.: Prevention of second primary tumors by an acyclic retinoid, polyprenoic acid, in patients with hepatocellular carcinoma. N Engl J Med 1996, 334:1561–1567.

    Article  PubMed  CAS  Google Scholar 

  6. Lau W, Leung W, Ho S, et al.: Adjuvant intra-arterial iodine-131-labelled Lipiodol for resectable hepatocellular carcinoma: a prospective randomised trial. Lancet 1999, 353:797–801. These are exciting data suggesting a role for adjuvant treatment following resection of HCC, but this study is from a single institution and involves a treatment not readily done in the United States.

    Article  PubMed  CAS  Google Scholar 

  7. Glasgow RE, Showstack JA, Katz PP, et al.: The relationship between hospital volume and outcomes of hepatic resection for hepatocellular carcinoma. Arch Surg 1999, 134:30–35.

    Article  PubMed  CAS  Google Scholar 

  8. Onik G, Rubinsky B, Zemel R, et al.: Ultrasound-guided hepatic cryosurgery in the treatment of metastatic colon carcinoma. Cancer 1991, 67:901–907.

    Article  PubMed  CAS  Google Scholar 

  9. Livraghi T, Bolondi L, Lazzaroni S, et al.: Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. Cancer 1992, 69:925–929.

    Article  PubMed  CAS  Google Scholar 

  10. Bilchik AJ, Rose DM, Allegra DP, et al.: Radiofrequency ablation: a minimally invasive technique with multiple applications. Cancer J Sci Am 1999, 5:356–361. This study demonstrates the safety and feasibility of radiofrequency ablation; the utility of this modality remains to be demonstrated.

    PubMed  CAS  Google Scholar 

  11. Mazzaferro V, Regalia E, Doci R, et al.: Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996, 334:693–699.

    Article  PubMed  CAS  Google Scholar 

  12. Lai C-L, Wu P-C, Chan GC-B, et al.: Doxorubicin versus no antitumor therapy in inoperable hepatocellular carcinoma. Cancer 1988, 62:479–483.

    Article  PubMed  CAS  Google Scholar 

  13. Leung TWT, Patt YZ, Lau W-y, et al.: Complete pathological remission is possible with systemic combination chemotherapy for inoperable hepatocellular carcinoma. Clin Cancer Res 1999, 5:1676–1681. This represents the first example of an effective combination chemotherapy for HCC. Whether this regimen will be as effective in other populations of HCC patients, such as Hepatitis C patients, needs to be tested.

    PubMed  CAS  Google Scholar 

  14. Farinati F, De Maria N, Fornasiero A, et al.: Prospective controlled trial with antiestrogen drug tamoxifen in patients with unresectable hepatocellular carcinoma. Dig Disease Sci 1992, 37:659–662.

    Article  CAS  Google Scholar 

  15. Riestra S, Rodriguez M, Delgado M, et al.: Tamoxifen does not improve survival of patients with advanced hepatocellular carcinoma. J Clin Gastroenterol 1998, 26:200–203.

    Article  PubMed  CAS  Google Scholar 

  16. Kouroumalis E, Skordilis P, Thermos K, et al.: Treatment of hepatocellular carcinoma with octreotide: a randomised controlled study. Gut 1998, 42:442–447.

    Article  PubMed  CAS  Google Scholar 

  17. Lai C-L, Lau JYN, Wu P-C, et al.: Recombinant interferon-a in inoperable hepatocellular carcinoma: a randomized controlled trial. Hepatology 1993, 17:389–394.

    Article  PubMed  CAS  Google Scholar 

  18. Nishiguchi S, Kuroki T, Nakatani S, et al.: Randomised trial of effects of interferon-a on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis. Lancet 1995, 346:1051–1055.

    Article  PubMed  CAS  Google Scholar 

  19. Robertson JM, Kessler ML, Lawrence TS.: Clinical results of three-dimensional conformal irradiation. J Natl Cancer Inst 1994, 86:968–974.

    Article  PubMed  CAS  Google Scholar 

  20. Patt YZ, Charnsangavej C, Yoffe B, et al.: Hepatic arterial infusion of floxuridine, leucovorin, doxorubicin, and cisplatin for hepatocellular carcinoma: effects of Hepatitis B and C viral infection on drug toxicity and patient survival. J Clin Oncol 1994, 12:1204–1211.

    PubMed  CAS  Google Scholar 

  21. Doci R, Bignami P, Bozzetti F, et al.: Intrahepatic chemotherapy for unresectable hepatocellular carcinoma. Cancer 1988, 61:1983–1987.

    Article  PubMed  CAS  Google Scholar 

  22. Kanematsu T, Furuta T, Takenaka K, et al.: A 5-year experience of lipiodolization: selective regional chemotherapy for 200 patients with hepatocellular carcinoma. Hepatology 1989, 10:98–102.

    Article  PubMed  CAS  Google Scholar 

  23. Venook AP: Treatment of hepatocellular carcinoma: too many options J Clin Oncol 1994, 12:1323–1334.

    PubMed  CAS  Google Scholar 

  24. Groupe d'Etude et de Traitement du Carcinome Hepatocellulaire: A comparison of Lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 1995, 332:1256–1261.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Hematology and Oncology, University of California, San Francisco, 400 Parnassus Avenue, Suite 502, 94143, San Francisco, CA, USA

    Alan P. Venook MD

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  1. Alan P. Venook MD
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Venook, A.P. Hepatocellular carcinoma. Curr. Treat. Options in Oncol. 1, 407–414 (2000). https://doi.org/10.1007/s11864-000-0068-z

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